Dear Editor: My vagina is my business; a young woman tries to tie her tubes at Mt Hope

“The doctor asked me no less than three times if I was sure I wanted to tie my tubes. I had to give her my life story and a bullet-point list of logical reasons why I didn’t want children.

“Even after all of that, she couldn’t help but write me two letters: one referring me for the procedure and the other explicitly stating that she advised against it and recommended an IUD instead…”

The following Letter to the Editor on a young woman’s attempt to make medical decisions related to her own body was submitted to Wired868 by Avah Atherton:

Photo: A young woman ponders life…

I’m sure you can agree with that. What goes into my vagina or what comes out of it: the whole package—ovaries, uterus, fallopian tubes—it’s all my business. Or it should be. That’s not the case when it comes to the women’s clinic at Mt Hope.

Let me back track. I managed to get a referral letter from the hospital in Arima. The doctor there asked me no less than three times if I was sure I wanted to tie my tubes. I had to give her my life story and a bullet-point list of logical reasons why I didn’t want children.

Even after all of that, she couldn’t help but write me two letters: one referring me for the procedure and the other explicitly stating that she advised against it and recommended an IUD instead. A small victory, but one I celebrated anyway, knowing the next part would be tough.

At my first visit to Mt Hope they just took the letter and told me to come back in three days time. Three days later, I’d only been there for five minutes when they told me to come back the following week to see the doctor and be screened. They could have spent five minutes making a phone call and I could have saved $15 in transport. Welcome to Trinidad.

It’s Thursday 11th October, International Day of the Girl, and I feel empowered. My appointment is at 8am but I get there on Trini time, half hour later. The waiting area has “No Eating” signs, so I stand further down the corridor and munch on a currants roll while waiting for my name to call.

The nurse asks me the same set of questions that I answered in Arima but I smile and answer them politely. I’m told there are no cups so I have to pee in the same pack they take the pregnancy test out of, in a unisex toilet with a broken door latch. No one walks in on me squatting over the toilet, so I’m still optimistic.

Photo: The Mt Hope Hospital.(Copyright News.Gov.TT)

I saw doctor after doctor, four in all, each one asking the same questions.

I got my hopes raised when one of them started checking the books for an appointment slot for me.The next available date was month-end. They try to do one surgery every week, she said. She watch meh again, bawl, “yuh sure?”—and then, doubting her own authority, ran outside to call a senior doctor to pass it on to.

The currants roll already digested, I can’t go too far in case I miss hearing my name being called; and, even if I did get food, I can’t eat in that area anyway. So, all optimism gone; and worse yet, ah hangry.

Finally, they say they spoke to some consultant who doesn’t advise I get the surgery due to my age and possible future regret. Allyuh serious?

The consultant stands next to his underling and preaches to me, saying how it goes against his conscience to perform the surgery. I point out his position in a public medical facility, that any possible future regret is mine to bear, and that I know of all the other birth control options, none of which have the permanency that I want.

He says I’m making a rash decision, that I can’t force him to do it, I don’t know what I’m saying, there are possible complications…

I say that having a child is a huge complication that I don’t want to risk. He says he doesn’t like my attitude and turns to walk away. Wow.

Photo: Wait… What?!

“Don’t let a boy touch yuh, else you would get pregnant,” is one of the old people sayings. In a world where birth control is the sole responsibility of a woman and in a country where women with too many children are shamed for not being able to keep their legs closed, I’m not allowed to not have children?

One recurring point was my age. But I’ve been a legal adult for 11 years and I’ve been making adult decisions for longer than that. With all the side effects of birth control and all the social, financial and personal considerations regarding childbirth/childcare/children, I still getting fight down for a decision that only affects me and my body?

A decision that would have a profound effect on my goals, my life and my future? Trinidad is not a real place, nah.

9 comments

Factors influencing physicians’ advice about female sterilization in USA: a national survey:

R.E. Lawrence,* K.A. Rasinski, J.D. Yoon, and F.A. Curlin

INTRODUCTION

Of particular concern for physicians is that some patients who undergo sterilization experience regret later on (MacKenzie et al., 2009). This is distressing for the patient (Kelekci et al., 2005), and potentially expensive if she chooses to undergo a surgical reversal or IVF (Curtis et al., 2006). Previous studies have linked regret to a number of patient characteristics including: young age at sterilization (Hillis et al., 1999; Kariminia et al., 2002; Curtis et al., 2006; Moseman et al., 2006; Jamieson, 2007; Ludermir et al., 2009), having few children at the time of sterilization (Kariminia et al., 2002), losing a child after the sterilization (Ludermir et al., 2009), feeling pressured by a partner (Moseman et al., 2006; Ludermir et al., 2009), entering a relationship with a new partner (Kariminia et al., 2002; Moseman et al., 2006; Ludermir et al., 2009) and having the procedure post-partum (Hillis et al., 1999; Kariminia et al., 2002; Ludermir et al., 2009). Some of these factors are unforeseeable, while others, if present at the time of the sterilization request, could raise a doctor’s suspicion that a patient is not an ideal candidate for sterilization.

RESULTS:

Physicians responded differently to a request for tubal ligation depending on the patient’s age, parity, and whether her husband was in agreement with the decision. The most controversial patient was a 26-year-old, G2P1, whose husband disagreed with the request. Seventy percent of physicians were somewhat or very likely to discourage her from pursuing sterilization at this time. The least controversial patient was a 36-year-old, G4P3, whose husband agreed with the request. Only 9% of physicians would discourage her from pursuing sterilization

This was a US study published in 2010. Appears that not only T&T are backward on these issues.

Sorry writer but you are not informed. This has nothing to do with a backward country, and everyrhing to do with malpractice and liability. You will not be able to get any doctor in any country to tie the tubes of any childless woman bellow the age of 35 because it doesn’t matter if you made the decision fully informed and mentally capable at the time, if you ever for any reason regret your decision and decide to sue the doctor, you will win the case and the doctor will lose their liscence, because it is against international medical guidelines.

As a person who is also childfree and have been doing tons of research on having this procedure done I knew from the get go that I would be turned away public. I’ve been saving to have it done private. It’s unfair but sometimes you have to pick you battles. Trinidad is too backwards to change its sexist ways for one person

Once more, and as quite clearly articulated by the writer, I observe that Trinidadians do not understand the concept of human rights.

I’ve reported doctors to the GMC in England for far less. No doctor in England wants the GMC breathing down his or her neck. But in Trinidad, the disciplinary body is as effective as a single sandbag in a tsunami.

Well articulated Avah. The approach to this sensitive and private matter and the lack of compassion is quite disturbing. I can understand if they advised you of the pros and cons of such a procedure (so that you are informed), as is their medical duty and responsibility, but this is not the case. In a time where women are fighting for equal rights, to dismiss this right is unfortunate.

Wherever we go in this society, there are systems, processes and procedures which suggest that women are not adults. There was a time when a woman had to get her husband’s written permission to have this process carried out; now doctors are suggesting that a woman cannot make a decision about her own body. Even if a woman subsequently regrets her decision to have a tubal ligation, she will have to live with those consequences. It is our bodies and our rights!

If some reports are to be believed, there was a time when such an experience was reserved for ladies of a certain race only. Ladies of the other race–I know, I know, there are more than two–were accommodated with alacrity and encouraged to get a ligation even when they had not asked for one.

How times have changed! Unless, of course, Ms Atherton’s surname misleads as far as her race is concerned.

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